Bushi Ganesh, Padhi Bijaya Kumar, Shabil Muhammed, Satapathy Prakasini, Rustagi Sarvesh, Pradhan Keerti Bhusan, Al-Qaim Zahraa Haleem, Khubchandani Jagdish, Sah Ranjit, Sah Sanjit, Anand Ayush
Global Center for Evidence Synthesis, Chandigarh 160036, India.
Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Diseases. 2023 Aug 7;11(3):103. doi: 10.3390/diseases11030103.
There is significant pathogenic and epidemiological overlap between diabetes and obstructive sleep apnea (OSA). This systematic review aimed to ascertain the association between OSA and cardiovascular disease (CVD) in a diabetic population.
The study protocol was registered with PROSPERO (CRD42023404126). On 15 July 2023, a comprehensive search of the literature was performed in PubMed, EBSCO, Scopus, ProQuest, and Web of Science, using keywords and synonyms of OSA, diabetes, and CVD, coupled with specific terms for different CVDs. Only observational studies that reported CVD events in diabetics (with and without OSA) were included. The quality of the studies included in the analysis was assessed using the Newcastle-Ottawa Scale.
In the primary literature search, 8795 studies were identified, of which 9 met the inclusion criteria and included 17,796 participants. Eight studies were eligible for meta-analysis, and a pooled risk ratio (RR) of 1.29 (95% CI = 0.91-1.83) was found for developing CVD in diabetics with OSA at a 95% prediction interval of 0.30-5.60. The included studies showed significant heterogeneity with an I value of 91%.
These findings show the possible association between OSA and diabetes and their impact on CVDs. Identifying and managing OSA in individuals with diabetes at an early phase could potentially reduce the risk of CVDs and its related complications.
糖尿病与阻塞性睡眠呼吸暂停（OSA）在致病机制和流行病学方面存在显著重叠。本系统评价旨在确定糖尿病患者中OSA与心血管疾病（CVD）之间的关联。
该研究方案已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42023404126）登记。2023年7月15日，在PubMed、EBSCO、Scopus、ProQuest和Web of Science数据库中进行了全面的文献检索，使用了OSA、糖尿病和CVD的关键词及同义词，以及不同CVD的特定术语。仅纳入报告了糖尿病患者（伴或不伴OSA）心血管疾病事件的观察性研究。使用纽卡斯尔-渥太华量表评估纳入分析的研究质量。
在初步文献检索中，共识别出8795项研究，其中9项符合纳入标准，纳入了17796名参与者。8项研究符合荟萃分析条件，发现伴OSA的糖尿病患者发生CVD的合并风险比（RR）为1.29（95%CI = 0.91 - 1.83），95%预测区间为0.30 - 5.60。纳入的研究显示存在显著异质性，I²值为91%。
这些发现表明OSA与糖尿病之间可能存在关联，以及它们对心血管疾病的影响。早期识别和管理糖尿病患者的OSA可能会降低心血管疾病及其相关并发症的风险。
